Wednesday, October 21, 2009

Who Pays?

When my husband has to undergo three root canals on the same tooth because the endodontist missed getting all the root during the first TWO root canals, who pays? Knowing we don't have dental insurance, he did not charge us for the second two procedures, but my poor husband still had to go through two extra ordeals. This doctor showed integrity toward us, but I wonder: How often across America, when patients have insurance, does a triple play due to doctor error generate triple insurance claims?

Last Friday my dad got prepped for surgery, then waited at the hospital for three hours before the cardiac surgeon came in to announce postponement of the surgery due to a urinary infection. Funny, his nurse had told my mom on the phone two days earlier that Dad might not have to go to the hospital Friday since the presurgery urinalysis showed infection. Too bad no one told us not to show up. My sister took off work to be there. I took off work to be there. Mom got Dad up and ready and to the hospital at the crack of dawn Friday. A dear, patient O.R. nurse got Dad all duded out in front and back hospital gowns, inserted an IV, shuttled him to the washroom any number of times, and made smalltalk with the four of us as we waited ... and waited ... and waited. After the doctor made his two-minute appearance to tell us what he had known two DAYS before, the nurse took out the IV, shuttled Dad to the washroom some more, got him back into his street clothes, and sent us off.

So who pays for this fiasco? The American taxpayer through Medicare? With all the current talk of health care reform, and the complex roles of insurance carriers, I don't even know who might bill whom for what in this scenario. But I do know who I could bill for our time and my sister's and my lost income ~ but only AFTER he eventually successfully performs my precious dad's surgery. (Perhaps this surgeon will act with integrity too; but since he didn't apologize to us, I doubt he understands the problem was a communication gap in his own office.)

But then I wonder if it's fair to expect doctors to be perfect. For decades, we bristled under the societal expectation to bow down to doctors as gods. Now they are human, and many take time to explain things to us, including the thinking behind their care strategies. We do seem to still operate in a culture that says a doctor's time is more important than a patient's time; hopefully, that can change too. But I love this "new humanity" and don't want to suggest we expect doctors to be superhuman again. Yet ~ who pays when a doctor does make a mistake?

In my personal scenarios above, the consequences to the patients were not grave. For that, we are all grateful. My husband's endodontist did the right thing; he ate the costs of the second and third root canals. We'll see what bills come for my dad's fiasco. Situations like this make me wish for a time when insurance companies do not stand between providers and customers. This would give doctors and patients opportunities to act honestly and rightly with each other ~ a free market. Sure would be simpler to figure out who pays.

1 comment:

tandemingtroll said...

I'm sorry about your dad's experience! I wonder if you or your mom could contact the doctor's office and proactively ask that the doctor pays for the hospital cost?

When I was pregnant with Jessi, my FP, who I used as an OB, decided to get out of the OB business because the insurance costs were skyrocketing. He transferred me to another group after I passed my due date because that was the date in which their insurance ran out. That new doctor didn't make it to the delivery in time and a third doctor pulled from the corridor had to deliver her. Eric and I both commented that we didn't want to see how many transactions that little ordeal generated.

I have wondered how much doctor's costs have increased since insurance was developed, which would cause people to need insurance more than before insurance existed. I am not even sure how to research the answer to this question.